title: Factors related to lymph node harvest: does a recovery of more than 12 improve the outcome of colorectal cancer?
abstract: OBJECTIVE
  The nodal harvest was studied to identify factors that affected the number of lymph nodes (LNs) retrieved in patients undergoing curative surgery for colorectal cancer. The influence of predictive factors on overall and disease-free 5-year survival was analysed.
  
  
  METHODS
  All patients diagnosed with colorectal cancer who underwent oncological resection consecutively from January 1996 to December 2011 in a single institution have been studied. Factors influencing LN retrieval were analysed. A logistic regression analysis was performed to determine the factors that predicted a recovery of more than 12 LNs. A Cox regression analysis was made to identify the predictive factors of overall and disease-free 5-year survival.
  
  
  RESULTS
  A total of 1166 patients were included in the study. The factors associated with the number of LNs harvested in surgical resections were age, colorectal surgeon, right colectomy, total colectomy, year of surgery, number of LN metastases and lymphocyte response. The factors that predicted a recovery of ≥ 12 LNs were age < 60 years, right colectomy, year of surgery and expert pathologist. A recovery of ≥ 12 LNs did not show significant differences in overall and disease-free 5-year survival, but the factor of colorectal surgeon did.
  
  
  CONCLUSIONS
  Number of LN metastases, lymphocyte response, type of surgical resection, age of patient and colorectal surgeon can predict the LN harvest. Survival in colorectal cancer, however, is probably more influenced by the performance of the operation by an expert surgeon than by recovery of more than 12 LNs.
authors.affiliation: Department of Surgery, Hospital de Sagunto, Valencia, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Moro-Valdezate
authors.forename: V
authors.initials: V
authors.lastname: Pla-Martí
authors.forename: J
authors.initials: J
authors.lastname: Martín-Arévalo
authors.forename: J
authors.initials: J
authors.lastname: Belenguer-Rodrigo
authors.forename: P
authors.initials: P
authors.lastname: Aragó-Chofre
authors.forename: M D
authors.initials: MD
authors.lastname: Ruiz-Carmona
authors.forename: F
authors.initials: F
authors.lastname: Checa-Ayet
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D003082:Colectomy; D003106:Colon / Q000473:pathology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010818:Practice Patterns, Physicians'; D016016:Proportional Hazards Models
keywords: Colorectal cancer; lymph node harvest; predictive factors